Psilocybin found to ease end-of-life anxiety in small study of patients with fatal cancer

Can the active ingredient in "magic mushrooms" help those with terminal cancer cope with their fate? That was the question asked by researchers, who published the results of their investigation September 6 in Archives of General Psychiatry.

After all, impending death wreaks havoc on the psyche of not only the terminally ill patient but also their family and friends. More broadly, our society spends so much time avoiding death that it can be well nigh impossible to cope with its reality.

To try and address this, UCLA psychiatrist Charles Grob and his colleagues enlisted 12 cancer patients—11 of them women—between June 2004 and May 2008. All suffered from fatal cancers, ranging from breast cancer to multiple myeloma, as well as "acute stress disorder, generalized anxiety disorder, anxiety disorder due to cancer, or adjustment disorder with anxiety." All agreed to take a "moderate dose" (0.2 milligrams per kilogram of body weight) of psilocybin (and niacin on another occasion) to see if the psychedelic drug might offer some relief from their fear of death and disease.

The unusual decision to have each patient serve as both a subjects and then as a control—rather than having two separate groups, one treated with psilocybin and one with niacin—was taken because the researchers believed "that to be the ethical course to take, given the life circumstances subjects were encountering," (i.e. imminent demise). In other words, Grob and his colleagues felt that all the terminally ill patients should be allowed to experience any potential benefit from the psilocybin treatment. The patients were brought into the hospital, hooked up to a heart monitor and settled in a room "decorated with fabric wall hangings and fresh flowers." Headphones played music of their choice. At 10:00 AM on the day of a treatment, each of the 12 patients in the study individually swallowed the appropriate dosage of psilocybin (or niacin for the control session) as a pill. Researchers then measured various vitals and checked on their status every hour thereafter until the psychedelic experience was over, roughly six hours later.

Eight of the 12 subjects had previous experience with hallucinogens, either in the past year or as far back as 30 years ago. Though heart rate and blood pressure climbed as a result of taking the drug, none reported a "bad trip" and most enjoyed a "significant" reduction in end-of-life anxiety between one and three months after treatment, as measured by various psychiatric questionnaires. Their depression eased as well—a change that was sustained as much as six months later for those who survived that long. Unfortunately, the psilocybin, at this dose anyway, did nothing for physical pain.

The patients generally reported that the medication helped them to examine their lives and determine "how they wished to address their limited life expectancy." Sadly, as of publication of the research, 10 of the 12 subjects have died. But the research suggests that using psychedelic drugs such as psilocybin may help to ease the existential anxiety and despair that modern medicine has largely found no other way to treat.

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